Provider Demographics
NPI:1922693456
Name:PROJECT WELLNESS, LLC
Entity Type:Organization
Organization Name:PROJECT WELLNESS, LLC
Other - Org Name:SANCTUARY OF HOPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S
Authorized Official - Phone:614-565-1294
Mailing Address - Street 1:153 E SPRING ST
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:OH
Mailing Address - Zip Code:45885-2311
Mailing Address - Country:US
Mailing Address - Phone:419-954-0102
Mailing Address - Fax:419-954-0138
Practice Address - Street 1:153 E SPRING ST
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:OH
Practice Address - Zip Code:45885-2311
Practice Address - Country:US
Practice Address - Phone:419-954-0102
Practice Address - Fax:419-954-0138
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROJECT WELLNESS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-06
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty